CHAPTER ONE

INTRODUCTION

1.1 Background

The breast milk alone is not sufficient to fulfill the dietary need of the child after 6 months. It’s necessary to introduce more supplementary diets with breast milk. Protein and iron supplements are also essential dietary component for an infant to prevent iron and protein deficiency.  This was backed by the search in Indian, where it was concluded that; poverty does not cause protein energy malnutrition in Indian but delayed introduction of complementary feeding can lead to malnutrition in growing children. Mothers were not aware and did not have adequate knowledge regarding how much food is required for a child, hence, Weaning is an important source of complementary with breast milk up to 2 years. (Harleen et al., 2022). The mother nurtures her child her like a small tree. Her weaning knowledge and practice decides the nutritional status of her infant and will affect their future development as well. The nutrition received by an infant in this period decides the rate of morbidity, mortality and certain chronic diseases. The introduction of complementary food do not only ensures the availability of nutrients that are deficient in mother’s meal, but also introduces the child to normal family food gradually. But giving solid food before 6 months increases feeding frequency, and can result in displacing of breast milk, which is unhealthy for the infant. (Manisha et al., 2022). WHO, 2019 recommended guide lines which suggest that mothers good health is necessary to exclusively breastfeed infants for 4-6 months, followed by complementary feeding (weaning), along with breast feeding, with consistency of solid food, and the inclusion of a varieties of food group to enhance infant nutritional requirements items of  macro and micro nutrients. Zeleke et al., 2017 found that 15.7% of breastfeeding mothers in Japan started weaning before 6 months of age, 6.15% in Norway started in the suggested age range (6-8) months and 13.4% in India started late (8-10) months.  A study carried out in Nigeria by Oche et al., ( 2019) among breastfeeding mothers showed that; timely introduction of complementary feed was commenced in 54% of the children, only 6.2 % wean their children at 6 month, 90.5% weaned their children gradually, and 63.5% bottle feed. According to them, factors influencing complementary and weaning practices were found to be child’s age, maternal age and family settings. According to the study carried out in Wajir Kenya, by Hassan et al., 2015 on the topic “determinants of early weaning” it was found that; majority of the lactating mothers (40%) introduced complementary or weaning food to their infants, from 3-4 month of life, while 31% and 27% of them introduced complementary or weaning food to their infants from 5-6 months and 1-2 months of life, respectively. Most common cause of early weaning were inadequate milk from mothers breast (42%). On cultural believes, majority (57%) blames the mother for lack of milk, while 21% feared their breast becoming shapeless.  This study showed that majority of lactating mothers commence the process of weaning prematurely, and the concept of exclusive breastfeeding has continued to meet a lots of resistance from all social class of the Wajir community.  Lastly, a study carried out in Adamawa, northern part of Cameroon by Ejoh et al, 2014 showed that; every 1 out of 3 children were malnourished due to poor and improper weaning process. According to this project, 77.1% of mothers introduced complementary food between the ages of 3 to 6 months. This shows that, the knowledge of weaning, its practice is still very less understood, and hence, needs to be addressed.

1.2 Statement of the Problem

Weaning has been one of the most wrongly practiced processes among breastfeeding mothers in the developmental stages of the children (Bahaa et al., 2019). It is an important but very delicate phase of the child. But even at this, most breastfeeding mothers have little knowledge on the importance, practice and appropriate time of weaning. (Saba Khan, 2016). Most women in developing countries especially in Africa, and Cameroon in particular, practice weaning but end up with one complication or another. (Cooke et al., 2013). Studies has also showed that, 11% 0f African mothers introduce solid food to their children, by the 5^th to the 6^th month, while 17% of other African women introduce food to their children, by the 3th and 4^th month. (Higgins et al, 2019). Poor weaning process has resulted to infant mortality (15%) and morbidity (10%) in the northern part of Cameroon (Ngambouk et al., 2014). 

The researcher during her internship at the regional hospital witness more than 5 cases of children with complications resulting from poor weaning from the Muea Health area. This search is therefore to assess the knowledge of breastfeeding mothers on weaning and its importance in the Muea medicalized health center.

1.3 Rational

This study will enable mothers have batter understanding on weaning, develop batter strategies in weaning infants and providing solutions to the challenges they face in the process of weaning .create on the needs of nutritional councilors in each health facilities and importance of health talk and food demonstration in all infants welfare clinic, this will reduce infants illnesses, mobility and mortality. 

1.4 Research Questions

1. l) What knowledge do mothers have on the weaning process in the Muea Health Area?

2) What are the Strategies used in weaning children 6-12 months by mothers in the Muea Health Area?

3) What are the challenges faced by mothers in Muea Health Area when weaning their babies?

1.4 Objectives

1.4.1General Objective

To assess mothers knowledge, attitude and practice on effective weaning of children 6-12 months in the Muea Health Area?

1.4.2 Specific Objectives

1. To assess mother’s knowledge on the weaning process in the Muea Health Area
2. To investigate the strategies used in weaning Infants 6-12months by mothers in the Muea Heath Area
3. To identify the challenges faced by mothers in practicing proper weaning of infants 6-12months in the Muea Health Area.